Increased risk of Ocular abnormalities in Extremely Preterm babies

In a new study conducted by Saurabh Jain and team it was found that extreme prematurity is linked to a higher incidence of visual and ocular abnormalities in early adulthood; however, this study further reveals that visual and ocular deficits are somewhat independent of retinopathy of prematurity (ROP) status in the neonatal period for those born Extremely preterm (EP), but that total visual function is similar.

The findings of this study were published in the Journal of American Medical Association.

Preterm babies (those born before 37 weeks of pregnancy) have a greater risk of vision impairment and ocular morbidity than full-term babies. However, for children born EP, who have the highest risk of neonatal retinopathy, the long-term ocular effects in adulthood remain unclear. As a result, the goal of this study was to compare visual function and ocular morbidity in young people born prematurely to controls at full term.

128 individuals aged 19 years (born at 22-25 weeks' gestation) and 65 age-matched controls born at full term were included in this prospective cohort research of a geographically based birth cohort in the UK and Ireland born from March 1 to December 31, 1995. From March 1, 2020, through November 26, 2021, statistical analysis was conducted. As part of a full outcome evaluation, participants had their eyes examined. The Health Utilities Index Mark 3 was used to assess best-corrected visual acuity, refractive status, contrast sensitivity, colour vision, the prevalence of strabismus and nystagmus, and patient-reported visual function.

The key findings are as follow:

1. 128 people (256 eyes; 68 female participants [53%]; mean [SD] age, 19.3 [0.5] years) and 65 age-matched controls born at full term were included in the research.

2. When compared to control eyes, the EP group's mean (SD) best-corrected visual acuity was considerably lower.

3. In comparison to the control group, the EP group showed a considerably greater prevalence of strabismus, aberrant ocular motility, and nystagmus.

4. There were no significant variations in refractive error, contrast sensitivity, colour vision, or patient-reported visual function between EP participants and controls.

5. The EP group had 48% of eyes with no ROP, 39% with ROP that did not require neonatal care, and 13% with ROP that required cryotherapy or laser ablation.

6. There was no significant difference in binocular visual function metrics, ocular morbidity prevalence, or patient-reported visual function by neonatal ROP status within the EP group.

In conclusion, these findings shed light on the ocular outcome of EP birth in the general population, and they have implications for the detection and treatment of such deficiencies as they develop over time.

Reference:

Jain S, Sim PY, Beckmann J, et al. Functional Ophthalmic Factors Associated With Extreme Prematurity in Young Adults. JAMA Netw Open. 2022;5(1):e2145702. doi:10.1001/jamanetworkopen.2021.45702